Lymphatic System Flashcards
Lymphatic system is part of the immune system that consists of:
• Vessels
• Nodes
• Ducts
• Tonsils
What is the function of the lymphatic system?
Helps fight disease processes and serves other functions in the body
What are lymphatic vessels?
A system of channels that parallel the venous blood vessels that are numerous than the venous blood vessels that drain tissue fluid as lymph.
Tissue fluid drains from the surrounding region into the
lymphatic vessels as lymph
Lymph nodes communicate with each other via
regional lymphatic drainage, which takes on a chain-like pattern
Lymphatic vessels are____ than the vascular system’s capillaries
larger and thicker
• Lymphatic vessels have ____similar to veins that ensure a one-way flow of lymph through the lymphatic vessel
one-way valves
Are lymphatic vessels found within tooth pulp?
Yes
What are lymph nodes?
Bean-shaped bodies grouped in clusters along the connecting lymphatic vessels that filter toxic products from the lymph to prevent toxins from entering the vascular system
Lymph nodes are composed of
organized lymphoid tissue and contain lymphocytes
What are lymphocytes?
White blood cells of the immune system that actively remove toxins to help fight disease processes in the body
Lymph nodes are composed of lymphoid tissue and contain lymphocytes. Where do the lymphocytes come from?
The nodes are also involved in the production of the lymphocytes
Where are lymph nodes located in relation to the vascular system?
Can be superficially located with superficial veins or located deep within the tissue with the deeper blood vessels
In healthy patients, lymph nodes are usually
small, soft, and free or mobile in the surrounding tissue
In healthy patients, lymph nodes ______when palpating their usual location during an extraoral examination of the head and neck
cannot be visualized or felt
Lymph node groups are named for
adjacent anatomical structures as well as their depth
Lymph nodes are linked down a chain of
lymphatic vessels
Lymph nodes can be classified as either _______based on their regional lymphatic drainage
primary or secondary
Lymph from a particular region first drains into a_____ before lymph flows to a more distant region
primary node
Lymph from primary nodes drain into
Secondary nodes
Located near airway and food passages to protect the body against disease processes from toxins.
Tonsils
These structures contain lymphocytes that remove toxins. Consist of masses of lymphoid tissue located in the oral cavity and pharynx
Tonsils
What are tonsils?
Masses of lymphoid tissues also containing lymphocytes located near the airway and food passages or in the oral cavity and the pharynx that remove toxins to protect the body against disease processes
Smaller lymphatic vessels containing lymph converge into______
larger lymphatic ducts
The lymphatic ducts from the small lymphatic vessels empty into the
venous drainage of the vascular system in the thorax
Lymphatic system of the right side of the head and neck converges by way of the___and joins the lymphatic system from the
right jugular trunk; right arm and thorax (chest) to form the right lymphatic duct
The right lymphatic ducts drain into the
venous drainage at the junction of the right subclavian and right internal jugular veins
Lymphatic vessels of the left side of the head and neck converge into the____then into the_____.
left jugular trunk; thoracic duct
The thoracic duct joins the venous drainage at the
junction of the left subclavian and left internal jugular veins
The lymphatic system from the left arm and thorax also joins the
thoracic duct
The thoracic duct is much larger than the right lymphatic duct. Why?
It drains the lymph from the entire lower half of the body for both the right and left sides
The right lymphatic duct and thoracic duct both each have ______at the junction with venous system
one-way valves
What are the functions of the one way valves of the right lymphatic and thoracic ducts?
Just like the other lymphatic valves in the lymphatic vessels, they prevent back flow, preventing venous blood from flowing into the lymph duct
Are lymph nodes of the head and neck paired?
Yes
What is the function of the lymph nodes?
Drain the right or left tissue, structures, or organs in each region, depending on their location
Lymph nodes are grouped based on ____
their location to nearby anatomic structures as well as their depth (superficial or deep)
There are how many groups of paired superficial lymph nodes in the head?
five
What are the five groups of paired superficial lymph nodes in the head?
• Occipital lymph nodes
• Posterior auricular lymph nodes
• Anterior auricular lymph nodes
• Superficial parotid lymph nodes
• Facial lymph nodes
Are the occipital lymph nodes paired?
Yes
How many occipital lymph nodes are there on each side (paired)?
1-3
Where are the occipital lymph nodes located?
Located on the posterior base of the head in the occipital region
What is the function of the occipital lymph nodes?
They drain the occipital region of the scalp
The occipital lymph nodes empty into
the deep cervical nodes
Are the Posterior Auricular Lymph Nodes paired?
Yes
On each side of the head (paired), there are how many posterior auricular lymph nodes per side?
1-3
Where are the posterior auricular lymph nodes located?
Located posterior to each auricle and external acoustic meatus
Are the Anterior Auricular Lymph Nodes paired?
Yes
On each side of the head, how many anterior auricular lymph nodes are there?
1-3
Where are the anterior auricular lymph nodes located?
Located immediately anterior to each tragus
Are the Superficial Parotid Lymph Nodes paired?
Yes
On each side of the head, how many superior parotid lymph nodes are there?
Up to 10
Where are the superficial parotid lymph nodes located?
Located just superficial to each parotid salivary gland
The posterior auricular, anterior auricular, and superficial parotid lymph nodes drain what structures?
• External ear
• Lacrimal gland
• Adjacent regions of the scalp and face
All of the superficial lymph nodes of the head empty into _____
the deep cervical lymph nodes
Are the facial lymph nodes paired?
Yes
On each side of the head, there are how many facial lymph nodes?
Up to 12
The facial lymph nodes are located along the ___
facial vein
The facial lymph nodes are categorized into how many subgroups?
four
What are the four subgroups of the facial lymph nodes?
• Malar lymph nodes
• Nasolabial lymph nodes
• Buccal lymph nodes
• Mandibular lymph nodes
Where are the malar lymph nodes located?
Located in the infraorbital region
Where are the nasolabial lymph nodes located?
Located along the nasolabial sulcus
Where are the buccal lymph nodes located?
• Located around the labial commissure
• Superficial to the buccinator muscle
Where are the mandibular lymph nodes located?
• Located in the tissue superior to the surface of the mandible
• Anterior to the masseter muscle
What is the function of the facial lymph nodes?
Drains the skin and mucous membranes in their respective regions. Also drain from one to another in a superior to inferior fashion before draining into the deep cervical nodes
Are the four subgroups of the facial lymph nodes paired?
Yes
There are how many groups of paired deep lymph nodes in the head?
Two
What are the two groups of paired deep lymph nodes in the head?
• Deep parotid lymph nodes
• Retropharyngeal lymph nodes
All of the deep lymph nodes of the head drain into the
deep cervical nodes
Are the Deep Parotid Lymph Nodes paired?
Yes
On each side of the head, how many deep parotid lymph nodes are there?
• Up to 10
Where are the deep parotid lymph nodes located?
Located deep within the parotid salivary gland
The deep parotid lymph nodes drain the______
middle ear, auditory tube, and parotid salivary gland
Are the Retropharyngeal Lymph Nodes paired?
Yes
On each side of the head, there are how many retropharyngeal lymph nodes?
Up to 3
Where are the retropharyngeal lymph nodes located?
Located near the deep parotid nodes, at the level of the atlas (first cervical vertebra)
The retropharyeangeal lymph nodes drain the____
area posterior to the palate, pharynx, paranasal sinuses, and nasal cavity
Are the cervical lymph nodes paired?
Yes
What is the function of the cervical lymph nodes?
• Unilaterally either drain the right or left tissue, structures, or organs in each region, depending on their location
• Except for the midline submental nodes, which drain the tissue in the submental triangle bilaterally
Where are the cervical lymph nodes located?
Located in either a superficial or deep position relative to the surrounding tissue in the neck
Groupings for the cervical lymph nodes are based on
their location to nearby anatomic structures as well as their depth (superficial or deep)
What are the four groups of paired superficial cervical lymph nodes in the neck?
Submental lymph nodes
Submandibular lymph nodes
External jugular lymph nodes
Anterior jugular lymph nodes
How many paired groups of cervical superficial lymph nodes are there?
Four
Are the Submental Lymph Nodes paired?
Yes
How many submental lymph nodes are on each side?
2-3
Where are the submental lymph nodes located?
Located inferior to the chin within the submental triangle; • Near the midline, inferior to the mandibular symphysis, superficial to the mylohyoid muscle
The submental lymph nodes bilaterally drain the ____
• lower lip
• both sides of the chin
• floor of the mouth
• apex of the tongue
• mandibular incisors with associated periodontium and gingiva
The submental lymph nodes empty into
the submandibular nodes or directly into the deep cervical nodes
What is the main cause of submental lymphadenopathy?
Most common cause of node enlargement is from infections involving mononucleosis syndromes, Epstein-Barr virus, cytomegalovirus, toxoplasmosis, and dental infections such as periodontitis
Are the submandibular lymph nodes paired?
Yes
How many submandibular lymph nodes are on each side?
3-6
Where are the submandibular lymph nodes located?
Located at the inferior border of the mandibular ramus; Superficial to the submandibular salivary gland
The submandibular lymph nodes unilaterally drain the ______
• cheeks
• upper lip
• body of the tongue
• anterior hard palate
• most of the teeth with associated periodontium and gingiva (except for the mandibular incisors and maxillary third molars)
Submandibular nodes may be_____ nodes for the submental nodes and facial regions
secondary
The lymphatic system from both the sublingual and submandibular salivary glands also drains into these nodes
Submandibular lymph nodes
The submandibular nodes empty into the____
deep cervical nodes
The most common cause of submandibular lymphadenopathy is from ____
infections of head, neck, sinuses, ears, eyes, scalp, and pharynx
Are the external jugular lymph nodes paired?
Yes
How many external jugular lymph nodes are on each side of the neck?
1-2
Where are the external jugular lymph nodes located?
Located on each side of the neck alongside the external jugular vein; Superficial to the SCM
The external jugular nodes may be secondary nodes for the____
occipital, posterior auricular, anterior auricular, and superficial parotid nodes
The external jugular lymph nodes empty into the
Are the Anterior Jugular Lymph Nodes paired?
Yes
Also called anterior cervical nodes
Anterior jugular lymph nodes
Where are the anterior jugular lymph nodes located?
Located on each side of the neck alongside the anterior jugular vein. Anterior to the larynx, trachea, and SCM muscle. Between the superficial layer of deep cervical fascia and the infrahyoid muscles
The anterior jugular lymph nodes drain the____and empty into the ____.
infrahyoid region of the neck; deep cervical nodes
How many deep cervical lymph nodes are there?
15-30
Where are the deep cervical lymph nodes located?
• Located along the length of the internal jugular vein on each side of the neck
• Deep to the SCM
• Extend from the base of the skull to the root of the neck
• Adjacent to the pharynx, esophagus, and trachea
The deep cervical lymph nodes can be divided into__
two paired groups
What are the two paired groups of deep cervical lymph nodes?
• superior deep cervical lymph nodes
• inferior deep cervical lymph nodes
Are the superior deep cervical lymph nodes paired?
Yes
Where are the superior deep cervical lymph nodes located?
Located beneath the SCM; Superior to the point where the omohyoid muscle crosses the internal jugular vein
One node of the superior deep cervical nodes, the jugulodigastric lymph node or tonsillar node can be prominent and palpable when the palatine tonsils undergo node enlargement or lymphadenopathy. The jugulodigastric lymph node are located inferior to the posterior belly of the digastric muscle and posterior to the angle of the mandible
The primary nodes of the superior deep cervical lymph nodes drain____
• posterior nasal cavity
• posterior hard palate
• soft palate
• base of the tongue
• maxillary third molars with associated periodontium and gingiva
• temporomandibular joint
• esophagus
• trachea
• thyroid gland
The superior deep cervical nodes may be secondary nodes for all other nodes of the head and neck, except___
inferior deep cervical nodes
The superior deep cervical lymph nodes empty into the
inferior deep cervical nodes or directly into the jugular trunk
Are the Inferior Deep Cervical Lymph Nodes Paired?
Yes
Where are the inferior deep cervical lymph nodes located?
• Located beneath the SCM
• Inferior to the point where the omohyoid muscle crosses the internal jugular vein
The Primary nodes of the inferior deep cervical lymph nodes drain the:
• posterior part of the scalp and neck
• Superficial pectoral region
• Part of the arm
• base of the tongue
The inferior deep cervical nodes may be secondary nodes for the____
superficial nodes of the head and superior deep cervical nodes
The inferior deep cervical lymph nodes ____form the jugular trunk.
efferent vessels
one of the tributaries of the right lymphatic duct on the right side and the thoracic duct on the left. The efferent vessels of the inferior deep cervical lymph nodes form this.
Jugular trunk
What are Efferent vessels?
channels that carry filtered lymph fluid away from lymph nodes, back to the bloodstream
The inferior deep cervical nodes also communicate with the ___that drain the breast region.
axillary lymph nodes
Which node of the Inferior Deep Cervical Lymph Nodes can be prominent and palpable?
The jugulo-omohyoid lymph node can potentially be palpated
Where is the jugulo-omohyoid located?
at the actual crossing of the omohyoid muscle and internal jugular vein
The jugulo-omohyoid drains the___
tongue and submental triangle as well as associated structures and regions
Associated with the lymphatic drainage of the tongue that if enlarged, it can be a sign of a tongue carcinoma
Jugulo-omohyoid lymph node
In addition to the deep cervical lymph nodes are the accessory and supraclavicular node groups which are located where?
Located in the most inferior part of the neck
The accessory lymph nodes are approximately ___in number
2 - 6
The accessory lymph nodes are located along the______
eleventh cranial or accessory nerve
The accessory lymph nodes drain the
scalp and neck regions
The accessory lymph nodes empty into the_____
supraclavicular nodes
The supraclavicular lymph nodes are approximately ___in number
1 -10
The supraclavicular lymph nodes are located___
superiorly along the clavicle close to where sternum joins it
The supraclavicular lymph nodes drain the
___
lateral cervical triangles
The supraclavicular lymph nodes empty into____
one of the jugular trunks or directly into the right lymphatic duct or thoracic duct
Apart of the the lymphatic system but NOT located along lymphatic vessels (as the lymph nodes are)
Tonsils
All tonsils drain into the
superior deep cervical lymph nodes
The three groups of tonsils are:
• Palatine tonsils
• Lingual tonsil
• Pharyngeal and tubal tonsil
What do the Palatine Tonsils look like?
Two rounded masses of variable size
Where are the palatine tonsils located?
located in the oral cavity between the anterior and posterior faucial pillars on each side of the fauces
What is the function of the palatine tonsils?
Help protect the body from infection
Trapping and filtering out germs that enter through the mouth or nose
An indistinct layer of lymphoid nodules located intraorally on the dorsal surface of the base of the tongue
Lingual tonsils
Where is the Pharyngeal Tonsil located?
Located on the midline of the posterior wall or roof of the nasopharynx.
This tonsil is also called the adenoids
Pharyngeal tonsil
slightly enlarged in children but can undergo even further enlargement with infection
pharyngeal tonsil
Help fight infection by trapping germs that enter the body through the nose and mouth
Pharyngeal tonsil
Where is the Tubal Tonsil located?
located in the nasopharynx, posterior to the openings of the eustachian or auditory tube
What is the function of the tubal tonsil?
Help to prevent bacteria from traveling up the tubes and causing middle ear infections
When a patient has a disease process such as cancer or infection active in a region, the region’s lymph nodes respond. The result is
increase in size and change in consistency of the lymphoid tissue or in other words lymphadenopathy
When more than one group of lymph nodes is enlarged, it is considered___.
generalized lymphadenopathy
Generalized lymphadenopathy commonly occurs with___
systemic infections
human immunodeficiency virus (HIV)
widespread cancers such as leukemia
The occurrence of lymphadenopathy may allow each lymph node to be visualized during an____ examination.
extraoral
Changes in consistency of lymph nodes allow each involved node to be felt when__ during the extraoral examination along the even firmer backdrop of underlying bones and muscles such as the SCM muscle or the clinician’s hands.
Palpated
Generally, lymph nodes must be larger than approximately____ to be palpable or visualized
10 mm in diameter
Enlarged nodes can be mobile or fixed. Enlarged nodes can be tender to palpation. Is this true?
Yes
Lymphadenopathy can also occur in the tonsils. Tissue enlargement of the tonsils (except for posteriorly located pharyngeal tonsils) can often been visualized during an___ examination of the patient
intraoral
Infectious mononucleosis is caused by the___
Epstein-Barr virus (EBV)
In cases of infectious mononucleosis, in teenagers and young adults, there is frequently what symptoms?
pharyngitis and inflamed palatine tonsils with exudate
the jugulodigastric lymph node or tonsillar node can be prominent and palpable when
the palatine tonsils undergo node enlargement or lymphadenopathy.
the jugulodigastric lymph node or tonsillar node can be prominent and palpable when
the palatine tonsils undergo node enlargement or lymphadenopathy.
